Patient Loses Vision from Rare Condition; Provider-Patient Relationship May Have Arisen via Phone

A patient consulted with an ophthalmologist regarding her eyes. The physician was a general ophthalmologist, but at a December 17, 2014, visit, he noted, in his differential diagnosis, that the patient might be suffering from bilateral acute retinal necrosis (BARN), an extremely rare condition that requires immediate treatment. The patient was referred to a retina specialist, but it is unclear whether the urgency of the referral was adequately conveyed to her.

A medical scribe called the specialty practice to schedule the appointment. She typed in the patient's chart that the ophthalmologist recommended referral to a retina specialist for potential BARN "within the next one to two days. Per the retina specialist to whom the patient was referred, patient can wait to be seen until next week. Appointment scheduled for 12/30/14." The December 30 appointment with the retina specialist was rescheduled for January 7, 2015, because the patient had travel plans to see her family. However, while she was traveling out of state, she experienced further vision problems, and she was diagnosed with BARN. The patient suffered severe loss of vision due...